Traditions Health LLC will pay $34 million to resolve its civil liability under the False Claims Act for billing medically unnecessary home health claims to Medicare and providing financial benefits to physicians in exchange for referrals, according to a Department of Justice news release. Traditions self-disclosed the conduct at issue to the government.
The settlement resolves allegations that, from 2021 to 2024, Traditions submitted claims to Medicare from its McAlester, Okla., location for home health services that were not medically necessary. It also resolves claims that, between 2019 and 2024, Traditions paid remuneration to physician-medical directors in Oklahoma and Texas who referred Medicare beneficiaries to Traditions for home health services and that this remuneration potentially violated the Anti-Kickback Statute and the Physician Self-Referral Law.
Following its independent investigation, Traditions provided detailed and thorough written disclosures to the government and cooperated with the government throughout the investigation, the DOJ noted. Traditions also promptly took remedial actions including removing individuals identified as responsible for the misconduct, improving its compliance program and providing additional training to its employees.